Job Description
Main purpose of the Job
To ensure that all Gap claims are accurately captured into the iMed system.
Position Specific Outputs
- Duplicate check claims received, and process claims and emails according to processes.
- Capture all claims received in accordance with relevant legislation and processes.
- Review and process case and non - case related claims in accordance with coding principles, scheme rules and benefits, and managed care policies and processes
- Providing coding review and resolution on call centre queries
- Assess claims edit requests and actioning it in accordance with coding principles, scheme rules and benefits, and managed care policies and processes
- Communicate with Stake holders
- Maintain clinical documents and processes
- Re...